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العنوان
Ultrasound Guided Bilateral Superior
Laryngeal Nerve Block Compared with Blind
Block Technique for Awake Fibre-optic
Intubation in Suspected Difficult Intubation /
المؤلف
Ali, Al Shaymaa Mortada.
هيئة الاعداد
باحث / الشيماء مرتضي علي
مشرف / عزة محمد شفيق عبدالمجيد
مشرف / عبير محمد عبدالعزيز الديك
مشرف / سناء محمد الفوال
تاريخ النشر
2021.
عدد الصفحات
104 P. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
التخدير و علاج الألم
تاريخ الإجازة
1/1/2021
مكان الإجازة
جامعة عين شمس - كلية الطب - قسم التخدير والرعاية المركزة وعلاج الالام
الفهرس
Only 14 pages are availabe for public view

from 104

from 104

Abstract

A
irway anesthesia is pivotal for successful awake intubation provided either topically or by nerves blocks. Airway blocks are considered technically more difficult to perform and carry a higher risk of complications. However, in experienced hands, they can be useful as they provide excellent intubating conditions.
Ultrasound has been widely used to locate nerves for various nerve blocks. The potential advantages of using ultrasound imaging for nerve blocks include reduction in the amount of local anesthetic required, improved success rate, reduced time to perform the block and reduced complication rate. We describe the successful performance of ultrasound-guided bilateral superior laryngeal nerve block to facilitate awake fibre-optic intubation.
Superior laryngeal nerve block can be performed easily, safely and with a high success rate in patients with normal air way anatomy. In those with difficult landmarks, ultrasound can be of assistance. For the superior laryngeal nerve block, other targets than the nerve itself must be established to make the technique successful, easy to teach, learn and perform.
Ultrasound imaging for superior laryngeal nerve block is more likely to be successful, takes less time to perform, and has a faster onset, longer duration, and fewer complications (such as intravascular or intra-neural injection) than the anatomical land mark method.
To achieve successful awake intubation, patient cooperation in combination with appropriate local anesthesia is essential. Superior laryngeal nerve block (SLNB) is an airway anesthesia technique that can paralyze posterior part of tongue, epiglottis, and cricothyroid muscle, and is thus expected to suppress the gag and cough reflexes and improve air way anesthesia.
With the development of new airway equipment such as indirect laryngoscopes, flexible FOI is being performed less frequently. However, it still plays a vital role in difficult airway management, as it allows the anesthetists to have a safe management plan for the anticipated difficult airway and a rescue strategy for the unanticipated difficult airway. Anesthetists should have a low threshold for using FOI when necessary, and if the decision is made to undertake it, serious consideration should be given to performing it in the awake patient.
The application of ultrasound marks a new era in airway management. Further studies are required to assess feasibility of ultrasound guided airway blocks, particularly in obese patients and patients with limited neck extension where identification of anatomical landmarks is difficult.